Medical image data information exchange system

ABSTRACT

[Problem] To efficiently and effectively exchange information on medical image data. 
     [Solution] A video image extracted from a DICOM file is uploaded from an upload terminal ( 6 ) to a server ( 2 ). A medical personnel accesses medical image data from a viewing terminal ( 8   a ) and plays the video image provided by the server. The user inputs a comment, into which link destination information to the medical image data is incorporated (inserted), via a comment input field on a medical image viewing screen.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a national stage application under 35 U.S.C. 371 ofPCT Application No. PCT/JP2014/000514 having an international filingdate of 31 Jan. 2014, which designated the United States, which PCTapplication claimed the benefit of Japanese Application No. 2013-089257filed 22 Apr. 2013, each of which are incorporated herein by referencein their entirety.

TECHNICAL FIELD

The present invention relates to a technique for exchanging informationon medical image data.

BACKGROUND ART

A PACS (Picture Archiving and Communication System) is a term used todescribe a set of medical image systems that store and manage digitalmedical image data from CR, CT, Mill and the like used in clinicalpractice, and use an online network to communicate and transfer thedigital medical image data. In general, the PACS refers to a set ofsystems that includes not only a medical image server and viewer, butalso a reporting system, a Radiology Information System (RIS) and thelike.

The DICOM (Digital Imaging and Communications in Medicine) standardserves as the standard for the PACS system. The DICOM standard is aglobal standard for medical image taken with Mill, CT or the like, anddefines mainly a data format and a communication specification ofmedical image information.

Following the DICOM standard, not only images taken with Mill or CT, butalso data related to medical practice such as motion video data, sounddata and the like created from endoscopes, ultrasounds or the like, canbe unified and managed. More specifically, any image data taken with adifferent type of digital image device in a different hospital can beshared through a network and a recording media.

Currently, there are various techniques utilizing a DICOM file (filescreated conforming to the DICOM standard) (JP-A-2005-278991 andJP-A-2009-142388).

JP-A-2005-278991 discloses a system in which medical image data includedin a DICOM file is used for a telediagnosis.

JP-A-2009-142388 discloses that a specific frame image included in theDICOM file is stored in association with a time-series order informationin order to reduce the operation burden when the image is read out fromthe second time onward. This makes it possible to, for example, play amotion video image from any desired point based on the specific frameimage having order information set by a user.

SUMMARY OF THE INVENTION Problem to be Solved by the Invention

However, according to a technique described in Patent Literature 1, itis possible to only exchange a comment on medical image data beingviewed, and it is thus difficult to make a comparison with or referenceto other medical image data. In addition, there has been a problem thatmedical image data in a DICOM file includes personal information such asthe name of the patient, and therefore is not suitable to be sharedunaltered with a plurality of people.

With the technique described in Patent Literature 2, a key image fordetermination of order information must be selected by a user, andtherefore, the operation has been cumbersome.

The purpose of the invention is to provide a system that enables theexchange of comments by simply linking to motion video data.

Means For Solving the Problem

(1)(2)(3)(4)(5) An image data providing system according to theinvention is characterized in that:

-   -   a server device includes;    -   a recording part that records each frame of motion video image        data as a still image and a consecutive number of playing order        as a motion video as a file name or an index name of each of the        still images and records a comment input from a terminal device,        first transmission means that receives a playing instruction        from the terminal device and transmits the still images, and        second transmission means that receives a link destination        acquisition instruction from the terminal device and acquires        the still image corresponding to the consecutive number        described in the file name or the index name included in the        link destination acquisition instruction, and then transmits the        still image,    -   wherein the terminal device includes first display control means        that displays a series of the still images transmitted from the        server device in response to the playing instruction as a motion        video by playing in consecutive numerical order described in the        file name or the index name and, also displays the comment, and        link destination acquisition instruction transmission means that        transmits the link destination acquisition instruction with the        consecutive number to the server device when a link displayed in        the comment is selected based on link information including the        consecutive number, and second display control means that        displays the still images transmitted from the server device in        response to the link destination acquisition instruction.

Thus, it is possible to link to an image that constitutes a part of themotion video recorded in the server directly and simply.

(6)(7)(8)(9)(10) An image data providing system according to theinvention is characterized in that:

-   -   a server device includes a recording part that records a motion        video image data and a comment, first transmission means that        receives a playing instruction from a terminal device and        transmits the motion video data, and second transmission means        that receives a link destination acquisition instruction from        the terminal device and acquires a frame image corresponding to        a frame number included in the link destination acquisition        instruction, and then transmits the frame image,    -   wherein the terminal device includes first display control means        that displays the motion video data and the comment transmitted        from the server device in response to a playing instruction,        link destination acquisition instruction transmission means that        transmits the link destination acquisition instruction with the        frame number to the server device when a link displayed in the        comment is selected based on the link information including the        frame number, and second display control means that displays the        frame image transmitted from the server device in response to        the link destination acquisition instruction.

Thus, it is possible to create a link without, for example, indexing tothe motion video.

(11) An image data providing system according to the invention ischaracterized in that, a terminal device includes a link informationinsertion means which, when a link operation is made by a user whendisplaying the motion video by the first display control mechanism,creates the link information specifying a frame number of displayedmotion video and inserts it in the comment.

Thus, the link to the image can be inserted in the comment by simpleoperations.

(12) An image data providing system according to the invention ischaracterized in that, a terminal device that includes a linkinformation insertion means in which a link operation is made by a userwhen displaying the motion video by the first display control means, andthen the link information specifying the consecutive number of displayedmotion video is created and inserted in the comments.

Thus, the link to the image can be inserted in the comment by simpleoperation.

(13) An image data providing system according to the invention ischaracterized in that, a server device includes means for storing auser's operation history of a terminal device when playing a motionvideo, and means for determining a display method of playing the motionvideo from a next time onward based on the user's operation history.

Thus, the display form when playing can be varied based on the user'sviewing history.

(14) An image data providing system according to the invention ischaracterized in that, an operation history which is the number of pauseoperations stored with respect to each frame of the image data.

Thus, the display form when playing can be varied depending on thenumber of pause operation by each user.

(15) An image data providing system according to the invention ischaracterized in that, an operation history displays frequency withrespect to each frame.

Thus, the display form when playing can be varied depending on thenumber of times that the motion video was played by each user.

(16) An image data providing system according to the invention ischaracterized in that, the first transmission means of the server devicetransmits information of a frame to be thumbnailed with the comment andthe motion video data, wherein the frame to be thumbnailed is determinedbased on the operation history.

Thus, an image believed to be important can be selected and thumbnailed.

(17)(18) A medical image data providing system according to theinvention is characterized by including means for extracting a pluralityof medical image data from contents data including a motion video imagedata, means for storing the user's operation history when playing themotion video image, and means for determining a display method when themotion video image is viewed from a next time onward based on thecontent of the user's operation history.

Thus, the display method of the motion video can be determined dependingon the user's operation history.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A is a diagram illustrating the configuration of a medical imagedata providing system according to the present invention;

FIG. 1B is a functional block diagram of a medical image data providingsystem according to the present invention;

FIG. 2 is a diagram illustrating the hardware configuration of medicalimage data providing system 2;

FIGS. 3A and 3B are diagrams illustrating a data example of the caseDB54;

FIG. 4 is a diagram illustrating a hardware configuration of uploadterminal 6;

FIG. 5 is a diagram illustrating a hardware configuration of viewingterminal 8;

FIG. 6 is a diagram illustrating a display example of a login screen;

FIG. 7 is a flowchart illustrating a processing when uploading;

FIG. 8 is a diagram illustrating a display example of an attributeinformation entry screen when uploading;

FIG. 9 is a flowchart illustrating a processing when inserting a framenumber in a comment;

FIGS. 10A and 10B are diagrams illustrating a display example of medicalimage data;

FIG. 11 is a diagram illustrating a data example of a comment historytable;

FIG. 12 is a flowchart illustrating processing when a frame number isclicked;

FIG. 13 is a diagram illustrating a display example of medical imagedata;

FIG. 14 is a diagram illustrating a display example of medical imagedata;

FIG. 15 is a diagram illustrating a data example of a mark incorporatedin a medical image data;

FIG. 16 is a flowchart illustrating a processing from accumulation of anoperation history to determination of display content when viewed fromthe next time onward;

FIG. 17 is a diagram illustrating a data example of content of anoperation when viewing;

FIG. 18 is a diagram illustrating a data example of display frequencywith respect to each frame;

FIGS. 19A and 19B are diagrams illustrating a content of an operationand a display frequency graphically;

FIG. 20 is a diagram illustrating a display example of a medical imagedata;

FIG. 21 is a diagram illustrating a display example of a medical imagedata; and

FIG. 22 is another diagram illustrating a display example of a medicalimage data.

EMBODIMENTS OF THE INVENTION 1. System Summary

As shown in the FIG. 1A, a medical image data information exchangesystem according to the present invention includes a medical image dataproviding system (server) 2 containing a database in which the motionvideo image is registered, and an upload terminal 6 and a viewingterminal 8 (8 a, 8 b) connected to the server 2 via a network 4. In thefollowing embodiment, an example that contents data is in a DICOM fileform will be described.

A motion video image (a plurality of medical image data) extracted fromthe DICOM file is uploaded to the server 2 from the upload terminal 6.The DICOM file is contents data including at least one or more motionvideo created in such a way that a doctor presses a foot button to turnon/off imaging when surgery. The motion video image includes, forexample, an angiographic motion video and a continuous image taken byCT, MRI, X-ray and the like while shifting spatially.

A user (medical personnel) who wishes to view a medical image accesses amedical image in the server 2 from the viewing terminal 8 a via aviewing program such as a web browser to play a motion video imageprovided by the server. The user also carries out an operation such as apause operation and a frame advance operation when playing the motionvideo image. At the same time, the operation is stored in the databaseof the server 2.

The user who views the motion video image, in a comment input field of amedical image viewing screen, inputs a comment into which linkdestination information to a specific medical image to be compared andreferred to is incorporated in association with the medical image. Thus,the user can access the medical image in the link destinationimmediately just by clicking a link part in the input comment.

Furthermore, a display method (such as highlighting of a frame in whicha pause operation was carried out many times) when the motion videoimage is viewed from next time onward is determined for a user whocarries out an operation of other viewing terminal 8 b based on anoperation history (including a pause operation) when playing the motionvideo image. Thus, a system that allows medical personnel to mutuallyexchange information can be established.

In the FIG. 1B, a functional block diagram of the system according toone embodiment of the invention is shown. A recording part 3 of theserver device 2 records each frame of the motion video data as stillimage 5. In addition, the frame number of the frame is assigned to filenames of each of the still images 5. Furthermore, the recording part 3also records a comment 7. The comment 7 is input by the user of theterminal device 8. A series of the still images 5 and the comment 7 areread out from the recording part 3 and transmitted to the terminaldevice 8 by first transmission means 9.

First display control means 13 of the terminal device 8 receives thestill images and the comment, and then displays them in a display part,wherein the still images are played in the order of the file names ofthe still images. The file names of the still images are frame numbers,resulting in playing the motion video. The comment 7 is also displayedtogether.

When the user of the terminal device 8 clicks a link embedded in thecomment 7, a link destination acquisition instruction including linkinformation is transmitted to the server device 2 by link destinationacquisition instruction transmission means 15. A URL based on the filenames of the still images 5 as link information is embedded in thecomment 7.

Second transmission means 11 of the server device 2 that received thelink information reads out the corresponding still image 5 from therecording part 3 and transmits it to the terminal device 8. Seconddisplay control means 17 of the terminal device 8 displays the stillimage 5 in the display part.

The details of the medical image data information exchange systemmentioned above will be described below.

2. Hardware Configuration

In the FIG. 2, a hardware configuration of a medical image dataproviding server 2 (FIG. 1) is shown.

The medical image data providing server 2 is composed of a PC containinga CPU 20, a memory 22, a display 24, a hard disk 26, a recording mediareader 27, and a keyboard/mouse 28, as shown in the FIG. 2.

The hard disk 26 records an OS (operating system) 50 such as WINDOWS™, acase registry program 52, a case DB 54, a medical image data informationdisplay program 56, and an operation history DB 58.

The case registry program 52 and the medical image data informationdisplay program 56 function in cooperation with the OS (operatingsystem) 50. The OS (operating system) 50, the case registry program 52and the medical image data information display program 56, which arerecorded in the recording media, are installed on the hard disk 26 viathe recording media reader 27.

In the FIG. 3, a data structure of a case DB 43 included in the medicalimage data providing server 2 is shown. Extraction of the image datafrom the DICOM file can be achieved by analyzing a data structure of theDICOM file and specifying an image at a specific position.

As shown in the FIG. 3A, the case is composed of an arbitrary number ofseries, and each series is composed of an arbitrary number of frames.One frame corresponds to one image file and is stored on the system in astate that the file name including a string of letters “[caseID]_[series ID]_[frame ID]” is given to the frame, so that the frame canbe uniquely identified in the system. As shown in the FIG. 3B, the framemay be maintained in a state that the frame can be uniquely identifiedby having information associating the letters with the file name in adatabase table. Hereinafter, “#” is used as a symbol representing theframe ID for illustrative purposes.

A user's operation history (such as a content of an operation, andnumber of operations) when viewing the motion video image is stored inthe operation history DB 58 (FIG. 2) of the medical image data providingserver 2 via the viewing terminal 8 (FIG. 1). A description of dataexample of the operation history DB 58 will be given later.

In the FIG. 4, a hardware configuration of the upload terminal 6(FIG. 1) is shown.

As shown in the FIG. 4, the upload terminal 6 is composed of a PCcontaining a CPU 60, a memory 62, a display 64, a hard disk 66, arecording media reader 67, and a keyboard/mouse 68. The hard disk 66records an OS (operating system) 70 such as WINDOWS™, and an uploader 72for uploading a medical image data. A user can access the medical imagedata providing server 2 via the uploader 72.

In the FIG. 5, a hardware configuration of the viewing terminal 8 (8 a,8 b) (FIG. 1) is shown.

As shown in the FIG. 5, the viewing terminal 8 is composed of a PCcontaining a CPU 80, a memory 82, a display 84, a hard disk 86, arecording media reader 87, and a keyboard/mouse 88. The hard disk 86records an OS (operating system) 90 such as WINDOWS™, a Web browser 92,a motion video playing script 94. A user can access the medical imagedata providing server 2 via the Web browser 92 to view the medical imagedata and its related information. In addition, the motion video playingscript 94 is a script for playing a plurality of the medical image datain the medical image data providing server 2 as a motion video on aclient side, and written in a language such as Java™.

3. Processing When Uploading a Medical Image Data

Next, a description for processing when uploading medical image datafrom the upload terminal 6 to the medical image data providing server 2is provided by using a flowchart shown in the FIG. 7. A processing afterlogin is shown in the flowchart shown in the FIG. 7.

A user who wishes to upload medical image data activates first theuploader 72. In an access screen (FIG. 6) displayed when the uploader 72is activated, when the user inputs a predetermined user ID and apassword, a login is completed through authentication of the medicalimage data providing server 2.

After login, the user specifies a DICOM file to be uploaded through thekeyboard/mouse 68 (step S12 in the FIG. 7). Thus, a plurality of images(for example, in JPEG format) are extracted (step S14), and compressedin a zip file with respect to each series (step S16). Though the DICOMfile is compressed into a zip file here, it may be compressed in otherformats.

Next, the compressed file is transmitted to the medical image dataproviding server 2, and then the motion video image is upload-processed(step S18). For example, when a DICOM file including five series ofmotion video images is selected, five compressed motion video files areuploaded to the medical image data providing server 2.

The medical image data providing server 2 stores whole received seriesassociated with one case ID in the case DB 54 shown in the FIG. 3 (stepS20). For example, “a3ef10” (FIG. 3) is granted as a case ID.

At this time, the medical image data providing server 2 stores eachframe of the motion video file with a given name as a still image. Forexample, in the FIG. 3A, extracted still images are each given a filename such as “a3ef10_5_001.jpg, a3ef10_5_002.jpg, a3ef10_5_003.jpg . . .”. “a3ef10” is a case ID, “5” is an ID representing that the fifthmotion video in the case ID, and “001, 002, 003 . . . ” are framenumbers. Accordingly, each frame of the motion video is stored as astill image in a format in which the frame number is included in thefile name.

Thus, a DICOM file having a large file size is compressed andtransformed into a format such as JPEG to reduce its file size whilebeing kept in a state with personal information deleted.

Furthermore, in a registration screen as shown in the FIG. 8, attributeinformation of the uploaded case and the like is separately input and aregistration button B1 is pressed by the user, and then the data istransmitted to the medical image data providing server 2 (step S22).Data, such as the name of an operator (Operator) and the age of apatient (Age) as the attribute information is input in a pull-down orfree description manner and transmitted to the server 2.

The medical image data providing server 2 stores the attributeinformation received from the upload terminal 6 associated with eachcase (for example, case ID “a3ef10”) in the case DB 54 (step S24).Uploading the case is thus completed. The DICOM file also includes suchattribute information to be input at this step, however, the user inputsthe attribute information without extracting the attribute informationincluding patient information from the DICOM data in this embodiment.This is because the attribute information and the like are registered ata level impossible to identify an individual.

4. Processing When Viewing Medical Image Data

A description of processing when viewing an uploaded medical image datais provided below using a flowchart shown in the FIG. 9 and a displayexample of a viewing screen shown in the FIG. 10A and B, etc.

A user activates the Web browser 92 (FIG. 5) of the viewing terminal 8and logins to the medical image data providing server 2, and then aviewing screen of a medical image data information as shown in the FIG.10A is first displayed. In the display shown in the FIG. 10A, a commentcolumn on the right side of the medical image display is blank. Inaddition, in the FIGS. 10A and 10B, a thumbnail of the medical imagedata (image cited in the comment) having high importance is displayed onthe left side of a main image area M.

A user specifies a case and presses a play button P, and then a seriesof still images corresponding to the case are transmitted from themedical image data providing server 2. The still images are played bythe viewing terminal 8 in the order of frames number included in filenames of the still images being transmitted. The motion video is thusdisplayed. A program for playing the still images in the order of theframe numbers included in the file names is provided from the medicalimage data providing server 2 as JAVASCRIPT, as described above.

A description is provided below of a case where a user plays and viewsthe motion video image, and pauses viewing at a position of frame ID“#131” to input a comment on an observation. Once the play button P ispressed, this button will be a pause button.

When a user presses an insertion button B2 below a comment input field Cdisplayed in the lower right portion of the viewing screen at a positionof the ID “#131” (step S32 of the FIG. 9), a link destinationinformation for accessing the currently displayed medical image ID“#131” (here, a repository URL of the still image recorded in theserver) is first inserted in the comment input field C as “#131” by ahyperlink (step S34). For example, a URL showing an address on theserver 2 storing the medical image data corresponding to“[a3ef10]_[1]_[131] shown in the FIG. 3A” is displayed in the commentinput field C as “#131” by a hyperlink. The link destination informationmay be inserted before inputting a comment or when inputting thecomment. In addition, link destination information to be inserted may bemedical image data in a series of different motion video images, or maybe medical image data of a different case.

The user further inputs a comment such as observation through thekeyboard/mouse 88 (FIG. 5), and presses an ENTER key (step S36). Theinput comment is thus associated with the ID of the user who input it asshown in the FIG. 11 and then, stored (accumulated) in the case DB 54 inchronological order (step S38). Accordingly, a comment “I made ajudgment that ×× by ∘∘. It is around “#131”.” as shown in the FIG. 10Bis displayed on a screen (step S40).

Next, a medical image data information display program 56 recognizesthat a user (for example, a user different from the above user) clicks alink part (for example) in the comment when viewing the motion video(“Yes” of step S42 in the FIG. 12), and then medical image data of thelink destination is read out from the case DB 43 (step S44) anddisplayed on the main image area M as shown in the FIG. 13 (step S46).

A screen display shown in the FIG. 13 shows a state after the link part“#131” included in the past comment is further clicked by a user whocommented on the frame “#441” from the state shown in the FIG. 10B. Theread out medical image data may also be displayed on a subscreenadjacent to the main image area M or displayed in an additional windowby mouseover (pop-up display) instead of displaying the read out medicalimage data on the main image area M.

As described above, a comment of a user (medical personnel whointerprets the image) on the case is accumulated and displayed on ascreen in chronological order together with a link destinationinformation (FIG. 13), and thereby an easy access to cited medical imagedata on a past comment can be achieved.

Furthermore, a mark as an identification label (such as an arrow) may beincorporated into the display area of the medical image (that is themedical image data) at the time of, for example, inputting the comment,by putting an arrow mark R in the medical image through thekeyboard/mouse 88 as shown in the FIG. 14.

For example, when the comment input in the step S38 in the FIG. 9 isstored, coordinate information about the arrow mark R put in the medicalimage associated with each frame may be stored in an additional table(FIG. 15). In an example shown in the FIG. 15, when the motion videoimage is viewed, a display frame is determined to be displayed seriallybefore and after the frame such that the arrow mark R is displayed justfor predetermined time (for example, for a few seconds). Thus, the arrowmark R put in a predetermined frame can be displayed at the next time ofplaying.

In the above, arrow mark R is incorporated into the specific frame ofthe medical image data, however, other ways, for example, enclosing aspecific area by a line or otherwise displaying using a luminancedifference without enclosing by a line may be used. In addition, anattribute (such as name, affiliation, specialism, and age) of the userwho input the comment may be displayed in conjunction with theidentification labeling.

5. Processing when operation histories are accumulated and the medicalimage is viewed from the next time onward.

FIG. 16 is a flowchart illustrating processing performed by the medicalimage data information display program 56 when a medical motion video isplayed.

When playing of the medical motion video is started (“Yes” of step 52shown in the FIG. 16), the CPU 20 of the medical image data providingserver 2 starts accumulating operation histories received from theviewing terminal 8 (step S54).

That is, the CPU 20 of the medical image data providing server 2 storesa user's operation history (such as a content of an operation and thenumber of operations) when viewing the motion video in the operationhistory DB 58. A content of the operation includes, for example, a pauseoperation, fast-forward operation, rewind operation, frame advanceoperation, frame return (reverse frame advance) operation and the like.

In the FIGS. 17 and 18, data examples of an operation kind table and adisplay frequency table included in the operation history DB 58 of themedical image data providing server 2 are shown, respectively.

In the operation type table shown in the FIG. 17, content of anoperation of each user associated with a frame ID when the operation isperformed is stored in chronological order. In the display frequencytable shown in the FIG. 18, the display frequency indicating a displayfrequency of the frame is stored with respect to each frame.

In the FIG. 19A, an example of a graphed display frequency (histogramdisplay) based on data in the display frequency table shown in the FIG.18 with respect to each frame is shown. In the FIG. 19B, an example of agraphed pause frequency (histogram display) with respect to each frame,when viewing based on the operation kind table shown in the FIG. 17, isshown.

When the CPU 20 of the medical image data providing server 2 recognizesthat a viewing of medical motion video is finished (for example, a stopbutton is pressed) (“Yes” of step S56), the CPU 20 determines a contentof a display from the next time of viewing based on the content of theoperation history described above (step S58).

For example, as shown in the FIG. 20, it is determined that the displayfrequency of a frame H is displayed as a histogram (FIG. 19A) inchronological order below the main image area M along a time bar T.Thus, a user (the user of the viewing terminal 8 b shown in the FIG. 1)who views a motion video from the next time onward can select a positioncorresponding to a part having high interpretation frequency in the past(peak of the histogram) to play and view.

Another display method, such as displaying the pause frequency whenviewing alone or together with the display frequency of the frame Hshown in the FIG. 20 as a histogram (FIG. 19B) below the main image areaM along the time bar T in chronological order with respect to each framemay be determined.

In addition, as shown in the FIG. 21, with respect to a frame having ahigh frequency of viewing by a specific user, an identification mark Sof the user may be displayed in a specific frame.

The basis for determination of identification labeling may be, withoutbeing limited to display frequency, a total display time of each frameor a point calculated by, for example, adding 2 points to the frameadvance operation. In addition, summing operation history data for allusers or limiting to only an operation history data of the specifieduser may be selected.

Thus, a display method from the next time onward is determined whileoperation history data are accumulated in the database every time theuser plays the motion video, and thereby, observations can beaccumulated among medical personnel to exchange information smoothly.

Other than the display method exemplified above, a display method inwhich the motion video is paused or played in slow motion at a position(frame) having high importance when play may be selected for the displaymethod when viewed from the next time onward.

Furthermore, in the FIG. 10 etc., a thumbnail of medical image data (animage cited in a comment) having high importance is displayed on theleft side of the main image area M, however the medical image datahaving high importance may be given color, given a mark, or givendifferent colors in a descending order of importance.

6. Other Embodiments

In the above embodiment, medical motion video data is played in sequenceby converting each frame of the medical motion video data into a stillimage data in JPEG format etc. and assigning file names to each stillimage data in the order of frame numbers. An effect that the medicalmotion video is played easily and also a link to each still image ismade easily is thus provided.

However, while there is an advantage in the method as described in theabove embodiment, there is the problem that a special playing programfor playing a motion video (for example, motion video playing script 94in the FIG. 3) is needed.

To solve this problem, an uncompressed motion video data may be recordedin the medical image data providing server 2, and the frame number ofthe uncompressed motion video data may be specified and linked. In thisinstance, unlike the previous embodiment, the motion video data isrecorded as a single file. In addition, since a frame number originallyprovided to the motion video data is used, there is no need to provide aseparate ID and the like.

Furthermore, motion video data as MPEG data etc. may be recorded in themedical image data providing server 2. In this instance, it is notpossible to link to each frame directly. Thus, linking is achieved asfollows.

A user clicks a reference button in the viewing terminal 8 shown in theFIG. 1, and then a frame number of an image being displayed at that timeis created as link information and transmitted to the medical image dataproviding server 2. The medical image data providing server 2 recordsthis frame number as link information together with a comment and thelike.

The link is clicked in the viewing terminal 8 at the time of referring,and then the frame number of the image is transmitted to the medicalimage data providing server 2. In the medical image data providingserver 2, based on this frame number, it is determined in which packetof the MPEG motion video data the frame number is included. Thisdetermination is made by referring the range of the frame numbersrecorded in the packet. The packet is thus specified, and then, imagesof a plurality of frames are created from the packet, and an image ofspecified frame number is extracted to be transmitted to viewingterminal 8.

The motion video image data is extracted from DICOM file in the aboveembodiment, however, without being limited to the DICOM file, the motionvideo image data may be extracted from other original standard data.

Only a medical image is displayed on the main image area M in the aboveembodiment, however, as shown in the FIG. 22, another image Z such asheart rate may also be displayed over the main image area M.

A comment is stored with respect to a case in the above embodiment,however, the comment may be stored with respect to each frame.

The medical image data providing system server 2 is a PC in the aboveembodiment, however, other devices (such as workstations) may also beused.

The upload terminal 6 and the viewing terminal 8 are PCs in the aboveembodiment, however, other devices (such as smartphones and tabletterminals) may also be used.

A plurality of images constituting a motion video are extracted from theDICOM file in the above embodiment, however, a series of still images(such as sectional images of CT taken from head to foot) may also beextracted.

The uploader 72 of the upload terminal 6 is used to upload a motionvideo image in the above embodiment, however, without being limited tothis, other means such as Web browser may also be used to upload themotion video image.

The Web browser 92 of the viewing terminal 8 is used to view a medicalimage data in the above embodiment, however, the medical image data mayalso be displayed by providing a dedicated application for viewing inthe viewing terminal 8 and using this application.

A plurality of sets of motion video images are included in a DICOM file(one case) in the above embodiment, however, the number of the motionvideo image included in the DICOM file (one case) may be one.

A motion video image extracted from a DICOM file on the upload terminal6 side is transmitted to the medical image data providing server 2 inthe above embodiment, however, the DICOM file may be transmitted to themedical image data providing server 2 as it is, and then extracted inthe medical image data providing server 2.

Medical image data (frame) of the same case are cited in the aboveembodiment, however, medical image data (frame) of other case may alsobe cited.

In the above embodiment, as illustrated in the FIG. 3A, a frame numberis used as a file name of a still image corresponding to each frame of amotion video to create a link to the file name. However, as illustratedin the FIG. 3B, each still image file may be provided with acorresponding ID and be stored as a table. In this instance, the ID isinserted as a parameter of the link from a viewing terminal, and themedical image data providing server 2 that received the ID acquires thecorresponding still image based on the ID and transmits to the viewingterminal.

1-18. (canceled)
 19. A medical image data providing system comprising:means for extracting a plurality of medical image data from contentsdata including motion video image data; means for storing a user'soperation history when playing the motion video image; and means fordetermining a display method when the motion video image is viewed fromthe next time onward based on the content of the user's operationhistory.
 20. A server device which is operable to communicate withplural terminal devices used by plural users: means for storing medicalmotion video image data; means for sending medical motion video imagedata responding to request from the terminal device; means for storingeach user's operation history when playing the motion video image at theterminal devices; and means for determining a display method when themotion video image is viewed from the next time onward based on thecontent of the user's operation history; wherein the display method ispausing the motion video image or playing the motion video image in slowmotion according to the user's operation history.
 21. A server deviceaccording to claim 20, wherein: the operation history is pausing. 22.Method for displaying motion video image, comprising: step for playingthe motion video image data responding to user's request; step forstoring each user's operation history when playing the motion videoimage; and step for determining a display method when the motion videoimage is viewed from the next time onward based on the content of theuser's operation history; wherein the display method is pausing themotion video image or playing the motion video image in slow motionaccording to the user's operation history.